Jacqueline Brittany Amsdell, P.A

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

4620 Issued in CT

Practice address

739 Irving Ave
Suite 640
Syracuse, NY 13210

Phone

(315) 464-6255

Fax

(315) 464-6251

NPI assigned

Jul 26, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jamsdell113592@direct.upstate.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1184974529

  Physician Assistant

  Medicare reassignment NPD
• TMH Physician Associates PLLC

  • Ophthalmology Physician
  • Houston, TX
  • NPI 1275779225
  Medicare reassignment NPD
• University Surgical Associates, LLP

  • Surgery Physician
  • Syracuse, NY
  • NPI 1376590117
  Medicare reassignment
• Suny Health Science Center at Syracuse

  • Pharmacy
  • Syracuse, NY
  • NPI 1306567474
  NPD
• TMH Physician Associates PLLC

  • Orthopaedic Surgery Physician
  • Spring, TX
  • NPI 1043061351
  NPD
• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  NPD (past)
• Medical Center Hospitalist Associates PLLC

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1770855710
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1700228129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 SALINA MEADOWS PKWY",
            "address_2": "STE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132124576",
            "telephone_number": "315-464-6255",
            "fax_number": "315-464-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE",
            "address_2": "SUITE 640",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-6255",
            "fax_number": "315-464-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMSDELL",
        "first_name": "JACQUELINE",
        "middle_name": "BRITTANY",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-26",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08521",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025830",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA08521",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "4620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335901004",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335901001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8745NY",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Amodei, FNP-C
• Kimberly M Amodio, PA
• Stephanie Amorosa, MD
• Kristen V Amous
• Ilya Amromin, MD
• Gary M Amundson, MD
• Ioana G. Amzuta, M.D.
• Noor Anabtawi, M.D.
• Nicholas William Anand, MD
• Dinesh Ananthan, M.D

• Surgical Physician Assistant in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.